Forms & publications

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Health Care Coverage Rights and Responsibilities

Form sharing Apple Health (Medicaid) clients rights and responsibilities for health care coverage under MAGI Medicaid, Health Insurance Premium Tax Credits (HIPTC) and Qualified Health Plans(QHP) and Qualified Dental Plans (QDP).
  • 18-003
  • Form
Alternate language versions:

Health Care Coverage Rights and Responsibilities - Classic Medicaid

Form sharing Apple Health (Medicaid) clients rights and responsibilities for health care coverage under Classic Medicaid.
  • 18-011
  • Form
Alternate language versions:

Health Care Coverage Rights and Responsibilities - Tailored Supports for Older Adults (TSOA) program

Form sharing Apple Health (Medicaid) clients rights and responsibilities for health care coverage under the Tailored Supports for Older Adults (TSOA) program.
  • 18-009
  • Form
Alternate language versions: